Abstract
Sarcopenia and frailty are common complications of end-stage liver disease. Sarcopenia, a progressive loss of muscle mass, strength, and function, is a key component of frailty, which is defined as an increased vulnerability to stressors due to a cumulative decline in physiologic reserve. Sarcopenia and frailty are separate but related concepts, and the presence of either portends poor prognosis. Liver transplantation (LT) is intuitively felt to be a cure as it leads to reversal of key drivers of both entities including malnutrition, hypogonadism, and systemic inflammation. There is a paucity of literature on the course and impact of both frailty and sarcopenia following LT. Available literature suggests a complex course without universal improvement in sarcopenia following LT. The ongoing presence of sarcopenia after LT is associated with poor outcomes. Intervention and management of risk factors are likely necessary to combat this entity. Frailty seems to improve following LT, but further research including long-term studies are needed in this area.
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References
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23.
Sinclair M, Gow PJ, Grossmann M, Angus PW. Review article: sarcopenia in cirrhosis – aetiology, implications and potential therapeutic interventions. Aliment Pharmacol Ther. 2016;43(7):765–77.
Montano-Loza AJ, Meza-Junco J, Baracos VE, Prado CM, Ma M, Meeberg G, et al. Severe muscle depletion predicts postoperative length of stay but is not associated with survival after liver transplantation. Liver Transpl. 2014;20(6):640–8.
Kalafateli M, Mantzoukis K, Choi Yau Y, Mohammad AO, Arora S, Rodrigues S, et al. Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score. J Cachexia Sarcopenia Muscle. 2017;8(1):113–21.
Lai JC, Feng S, Terrault NA, Lizaola B, Hayssen H, Covinsky K. Frailty predicts waitlist mortality in liver transplant candidates. Am J Transplant. 2014;14(8):1870–9.
Dasarathy S, Merli M. Sarcopenia from mechanism to diagnosis and treatment in liver disease. J Hepatol. 2016;65(6):1232–44.
Bhanji RA, Carey EJ, Yang L, Watt KD. The long winding road to transplant: how sarcopenia and debility impact morbidity and mortality on the waitlist. Clin Gastroenterol Hepatol. 2017;15(10):1492.
Dasarathy S. Posttransplant sarcopenia: an underrecognized early consequence of liver transplantation. Dig Dis Sci. 2013;58(11):3103–11.
Bhanji RA, Narayanan P, Allen AM, Malhi H, Watt KD. Sarcopenia in hiding: the risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis. Hepatology. 2017;66(6):2055–65.
Carey EJ, Lai JC, Wang CW, Dasarathy S, Lobach I, Montano-Loza AJ, et al. A multi-center study to define sarcopenia in patients with end-stage liver disease. Liver Transplant. 2017;23(5):625–33.
Hussaini SH, Oldroyd B, Stewart SP, Soo S, Roman F, Smith MA, et al. Effects of orthotopic liver transplantation on body composition. Liver. 1998;18(3):173–9.
Krasnoff JB, Vintro AQ, Ascher NL, Bass NM, Dodd MJ, Painter PL. Objective measures of health-related quality of life over 24 months post-liver transplantation. Clin Transpl. 2005;19(1):1–9.
Krasnoff JB, Vintro AQ, Ascher NL, Bass NM, Paul SM, Dodd MJ, et al. A randomized trial of exercise and dietary counseling after liver transplantation. Am J Transplant. 2006;6(8):1896–905.
Tsien C, Garber A, Narayanan A, Shah SN, Barnes D, Eghtesad B, et al. Post-liver transplantation sarcopenia in cirrhosis: a prospective evaluation. J Gastroenterol Hepatol. 2014;29(6):1250–7.
Jeon JY, Wang HJ, Ock SY, Xu W, Lee JD, Lee JH, et al. Newly developed sarcopenia as a prognostic factor for survival in patients who underwent liver transplantation. PLoS One. 2015;10(11):e0143966.
Bergerson JT, Lee JG, Furlan A, Sourianarayanane A, Fetzer DT, Tevar AD, et al. Liver transplantation arrests and reverses muscle wasting. Clin Transpl. 2015;29(3):216–21.
Bhanji RA, Carey EJ, Watt KD. Review article: maximising quality of life while aspiring for quantity of life in end-stage liver disease. Aliment Pharmacol Ther. 2017;46(1):16–25.
Kallwitz ER. Sarcopenia and liver transplant: the relevance of too little muscle mass. World J Gastroenterol. 2015;21(39):10982–93.
Lai JC, Covinsky KE, Dodge JL, Boscardin WJ, Segev DL, Roberts JP, et al. Development of a novel frailty index to predict mortality in patients with end-stage liver disease. Hepatology. 2017;66(2):564–74.
Lai JC, Segev DL, McCulloch CE, Covinsky KE, Dodge JL, Feng S. Physical frailty after liver transplantation. Am J Transplant. 2018;18(8):1986–94.
McAdams-DeMarco MA, Isaacs K, Darko L, Salter ML, Gupta N, King EA, et al. Changes in frailty after kidney transplantation. J Am Geriatr Soc. 2015;63(10):2152–7.
Jha SR, Hannu MK, Newton PJ, Wilhelm K, Hayward CS, Jabbour A, et al. Reversibility of frailty after bridge-to-transplant ventricular assist device implantation or heart transplantation. Transplant Direct. 2017;3(7):e167.
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Bhanji, R.A., Carey, E.J. (2020). Physical Frailty and Sarcopenia in End-Stage Liver Disease: Do They Improve After Liver Transplantation?. In: Tandon, P., Montano-Loza, A. (eds) Frailty and Sarcopenia in Cirrhosis. Springer, Cham. https://doi.org/10.1007/978-3-030-26226-6_13
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DOI: https://doi.org/10.1007/978-3-030-26226-6_13
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